Endocrine Abstracts

A 73 year old male presented to his optician with reduced vision in his right eye. He was found to have a right sided visual field defect and referred to Opthalmology. An MRI scan was arranged which showed a 29 x 22 x 17mm pituitary fossa mass, elevating and flattening the optic chiasm. He was therefore referred urgently to Endocrinology. He denied any symptoms other than some lethargy, a mild headache and erectile dysfunction. His anterior pituitary function tests are display...

Case history: A 16 month old boy was referred to Community Paediatrics with developmental delay. Bloods taken as part of a developmental delay screen, revealed a raised calcium, with an inappropriately normal parathyroid hormone (PTH) and a normal vitamin D. There was no family history of hypercalcaemia. Blood tests in the boy’s mother and grandmother also showed hypercalcaemia.Investigations: Calcium was raised at 3.46 mmol/l. A urinary calcium cre...

A 73-year-old female with previous tuberculosis, primary hypothyroidism, depression and caecal cancer was referred to Endocrinology when interval CT scanning reported a 2.5 cm adrenal mass, stable in size over 4 years. No symptoms or signs of hormonal production were noted. Screening tests were abnormal: post-1 mg dexamethasone cortisol was 98 nmol/l, 24-h urinary free metadrenaline was elevated tenfold (3256 nmol/24 h, range 0–350) to a concentration reported to have hig...

A 56-year-old male presented in 2017 with acute symptomatic hyponatraemia. He was admitted with a seizure and a plasma sodium of 112 mmol/l. His past medical history was notable for alcohol excess and smoking. The acute presentation was managed with 3% hypertonic saline infusion in ITU. Plasma osmolality was 240 mOsm/Kg, urine osmolality 327 mOsm/kg and sport urine sodium 28 mmol/l. CT TAP showed some oesophageal thickening only; endoscopy was normal. He made a good recovery f...

A 77 year old female was referred to endocrinology with an incidental finding of hypophosphataemia (0.26 mmol/l) on routine bloods. She described a slight unsteadiness on her feet, but denied bone pain or overt muscle weakness. Past medical history included Type 2 Diabetes Mellitus, a left humeral fragility fracture and the subsequent diagnosis of osteoporosis 2 years previously. At presentation the corrected calcium was slightly elevated (2.64 mmol/l), which normalised when r...

History: A 63 year old female presented with nausea, vomiting and loss of balance. She had no other symptoms. An MRI of the brain revealed a large incidental pituitary lesion occupying both the sella and suprasellar region, causing distortion of the optic chiasm and tracts. She had no headache, visual disturbance, tiredness, thirst or daytime frequency although she had long standing nocturia.Examination: Visual fields showed mild bitemporal desaturation ...

Introduction: AMH is produced by the sertoli cells in the testes and is responsible for the regression of the Mullerian structures in the male fetus. It is also produced by the granulosa cells of the ovaries in females to a lesser degree. Serum AMH measurements may be important for detecting testicular tissue and monitoring ovarian activity. The objective of this study was to establish a cross-sectional reference range for AMH in UK children.Method: Seru...

Hyponatraemia is commonly encountered in neurosurgical units. Salt wasting syndrome is rare, and thought to occur due to ANP- and BNP-mediated natriuresis, leading to hypovolemic hyponatraemia. A 31 year old male was transferred to the National Neurosurgical Unit with a 12 hour history of back pain, progressive lower limb weakness and sensory loss. MRI demonstrated an epidural haematoma, extending from C7 to T3, and he underwent emergency decompressive laminectomy. Vasopressin...

Aim: The short Synacthen test (SST) is an established test used to assess the hypothalamic-pituitary-adrenal axis. There remains debate whether a 30 minute or 60 minute cortisol sample has diagnostic superiority. Currently at the Queen Elizabeth University Hospital, Glasgow all tests arranged by endocrinology are performed by endocrine nurse specialists who utilise a 0 and 30 minute cortisol protocol. Performing a further 60 minute sample requires more nursing time and space r...

Introduction: The incidence of adrenal insufficiency in cases of unexplained death in young children is unclear. It is also unclear whether there is a relationship between adrenal size and plasma cortisol concentration.Methods: All post-mortem (PM) reports of sudden deaths in children in the West of Scotland between 2010 and 2012 were retrospectively analysed. Combined adrenal weight (g) was recorded and expressed as the percentage of total body weight (...